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目的探讨高血压病患者血压晨峰(morning blood pressure surge,MBPS)与左心室重构的关系。方法对80例高血压患者资料进行回顾性分析,依据24h动态血压(ambulatory blood pressure monitoring,ABPM),将MBPS值≥35mmHg列入MBPS组(32例),MBPS值<35mmHg列入非MBPS(48例),计算患者的高血压病程、身高体质指数(BMI),常规检查总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG),通过心电图测量患者左心室电压,通过心脏超声计算左心室质量指数(LVMI),比较分析两组的MBPS值,分析左心室肥厚(left ventricular hypertrophy,LVH)的危险因素,分析MBPS与LVH的关系及危险性。结果两组患者BMI、TC、TG、HDL-C、LDL-C和FPG差异均无统计学意义(P>0.05)。MBPS组高血压病程为(22.69±4.32)年,非MBPS组为(17.42±4.55)年,差异有统计学意义(P<0.01)。MBPS组左心室电压为(5.03±0.46)mV,非MBPS组为(4.76±0.53)mV,差异有统计学意义(P<0.05);MBPS组24h平均收缩压、24h平均舒张压、24h平均血压分别为(139.66±3.09)、(76.86±4.15)、(108.25±3.17)mmHg,非MBPS组分别为(138.08±2.07)、(75.02±4.34)、(107.42±3.19)mmHg,MBPS组24h平均收缩压与24h平均血压高于非MBPS组,差异有统计学意义(P<0.05);MBPS组LVMI为(123.44±3.35)g/m2,非MBPS组为(121.60±3.27)g/m2,差异有统计学意义(P<0.05);MBPS组MBPS值为(37.44±1.66)mmHg,非MBPS组为(24.67±4.11)mmHg,差异有统计学意义(P<0.01)。MBPS组LVH的发生率(56.25%)高于非MBPS组(29.常7%),差异有统计学意义(P<0.01),MBPS是LVH的独立危险因素,有MBPS比非MBPS者风险高1.10倍。结论 MBPS与左心室重构的发生密切相关,高血压患者有MBPS者更易发生左心室重构。
Objective To investigate the relationship between morning blood pressure surge (MBPS) and left ventricular remodeling in patients with essential hypertension. Methods The data of 80 hypertensive patients were retrospectively analyzed. According to 24h ambulatory blood pressure monitoring (ABPM), the MBPS value was ≥35mmHg in the MBPS group (32 cases) and the MBPS value was less than 35mmHg in the non-MBPS The patients were enrolled in the study. The patients were enrolled in the study. The patients were enrolled in the study. The patients were enrolled in the study. The patients’ hypertension course, BMI, TC, TG, HDL-C and LDL (Left ventricular voltage was measured by electrocardiogram, left ventricular mass index (LVMI) was calculated by echocardiography, MBPS values were compared between the two groups, and the left ventricular hypertrophy (LVH) Risk factors, analyze the relationship between MBPS and LVH and risk. Results There was no significant difference in BMI, TC, TG, HDL-C, LDL-C and FPG between the two groups (P> 0.05). The course of hypertension in MBPS group was (22.69 ± 4.32) years, compared with (17.42 ± 4.55) years in non-MBPS group, the difference was statistically significant (P <0.01). The left ventricular voltage was (5.03 ± 0.46) mV in MBPS group and (4.76 ± 0.53) mV in non-MBPS group, the difference was statistically significant (P <0.05); MBPS group 24h mean systolic blood pressure, 24h mean diastolic blood pressure, 24h mean blood pressure (139.66 ± 3.09), (76.86 ± 4.15) and (108.25 ± 3.17) mmHg in non-MBPS group were (138.08 ± 2.07), (75.02 ± 4.34) and (107.42 ± 3.19) mmHg, (P <0.05). The LVMI of MBPS group was (123.44 ± 3.35) g / m2, while that of non-MBPS group was (121.60 ± 3.27) g / m2, the differences were statistically significant (P <0.05). The MBPS value in MBPS group was (37.44 ± 1.66) mmHg, while it was (24.67 ± 4.11) mmHg in non-MBPS group. The difference was statistically significant (P <0.01). The incidence of LVH in MBPS group (56.25%) was higher than that in non-MBPS group (29.7%), the difference was statistically significant (P <0.01). MBPS was an independent risk factor of LVH, 1.10 times. Conclusions MBPS is closely related to the occurrence of left ventricular remodeling. Patients with MBPS are more likely to have left ventricular remodeling.